title: Child health insurance coverage and household activity toward child development in four South American countries.
abstract: We evaluate the association between child health insurance coverage and household activities that enhance child development. We use micro-level data on a unique sample of 2,370 children from four South American countries. Data were collected by physicians via in-person interviews with the mothers. The regression models compare insured and uninsured children seen within the same pediatric care practice for routine well-child care and adjust for several demographic and socioeconomic characteristics. We also stratify these analyses by selective household demographic and socioeconomic characteristics and by country. We find that insurance coverage is associated with increasingly engaging the child in development-enhancing household activity in the total sample. This association significantly varies with ethnic ancestry and is more pronounced for children of Native or African ancestry. When stratifying by country, a significant positive association is observed for Argentina, with two other countries having positive but insignificant associations. The results suggest that insurance coverage is associated with enhanced household activity toward child development. However, other data and research are needed to estimate the causal relationship.
authors.affiliation: Department of Health Management and Policy, College of Public Health, University of Iowa, 105 River Street, N248 CPHB, Iowa City, IA, 52242, USA, george-wehby@uiowa.edu.
authors.forename: George L
authors.initials: GL
authors.lastname: Wehby
mesh_terms: D002648:Child; D002657:Child Development / Q000502:physiology*; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005191:Family Characteristics; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000191:economics* / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000191:economics* / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008297:Male; D012044:Regression Analysis; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013019:South Africa